Provider Demographics
NPI:1346796422
Name:TT HEALTHCARE INC
Entity Type:Organization
Organization Name:TT HEALTHCARE INC
Other - Org Name:986 PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO / PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:QUANG
Authorized Official - Middle Name:
Authorized Official - Last Name:THAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-456-3862
Mailing Address - Street 1:8054 GARVEY AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2449
Mailing Address - Country:US
Mailing Address - Phone:626-988-0106
Mailing Address - Fax:626-988-0107
Practice Address - Street 1:8054 GARVEY AVE STE 101
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2449
Practice Address - Country:US
Practice Address - Phone:626-988-0106
Practice Address - Fax:626-988-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY53725333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2163897OtherPK